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General NPI Number Information
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NPI Number | 1992704357
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Entity Type | Individual
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Provider Name | RONALD K JAEKLE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 1930 ALCOA HWY STE A435
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City | KNOXVILLE
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State | TN
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Zip | 37920-1520
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Country | US
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Telephone | 865-263-2400
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Fax | 865-263-2441
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Provider Business Mailing Address
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Address Line | 1930 ALCOA HWY STE A435
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City | KNOXVILLE
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State | TN
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Zip | 37920-1520
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Country | US
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Telephone | 865-263-2400
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Fax | 865-263-2441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 29190
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 28922
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 35-061570
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License Number State | OH
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